Managing self-limiting infections in community pharmacies: a cluster randomised controlled trial
PHE ePoster Library. Gold N. Apr 9, 2019; 259609; 15577
Dr. Natalie Gold
Dr. Natalie Gold
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Abstract Background: Community pharmacy teams are key in contributing to tackling antimicrobial resistance (Background: Community prescribing accounts for 74% of antibiotic prescribing in England and the number of bloodstream infections caused by resistant organisms continues to rise. Community pharmacy teams have a key role in tackling antimicrobial resistance (AMR). Purpose: The aim of the study was to assess the impact of giving pharmacy teams training in antimicrobial stewardship (AMS) and a tool to manage self-limiting infections, on the proportion of patient consultations resulting in GP referral, or provision of self-care advice (with or without products) or information.


The study (granted ethics approval) was conducted as a non-blind cluster randomised controlled trial. Pharmacies in the intervention arm received webinar training on AMR, AMS and use of a published evidence-based infection management leaflet (TARGET). This was followed by use of the leaflet as part of everyday practice for two weeks. Control arm pharmacies continued with usual practice.


66.91% (182 of 272) of pharmacies provided 3649 patient consultation data across both arms. Descriptive analysis suggested that the proportion of consultations with recommendation to purchase medicines, provision of written information and GP referral was similar for both arms. The intervention arm provided more self-care advice than the control (p=0.015), whilst pharmacy support staff referred patients to pharmacists more often in the control arm (p<0.01). Further analysis highlights differences for GP referrals between arms.


Use of the TARGET leaflet may have facilitated pharmacy staff giving more self-care advice and may be linked to reduced pharmacist referral. GP referral findings varied according to patient characteristics.
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